Provider First Line Business Practice Location Address:
USA MEDDAC KAHC
Provider Second Line Business Practice Location Address:
700 24TH STREET BLDG. 8151
Provider Business Practice Location Address City Name:
FT LEE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23801-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-734-9081
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2007